Things are unbelievably terrible out there right now.

Forget anything you’ve heard about Omicron being “mild.” It is HORRIFIC how it is ravaging our society and our hospitals and our health care workers.

11,000 cases/day in June in the US.

650,000 cases yesterday (plus a gabillion unreported at-home tests)

Please do everything you can to not get Omicron this month.

Get boosted. (Get vaccinated!) Wear a good mask everywhere. Hunker down. Don’t congregate inside with unmasked people. Don’t eat inside with strangers. Minimize travel. Do what you can to not get hurt or sick or quarantine-stranded.

Our hospital systems are beyond stressed: the ER’s hallways are full of patients, the ICUs are full up, the Urgent Cares have lines around the block, the PCPs are getting pounded, the pediatricians have exploding clinics.

In addition, if you get seriously ill right now, there are essentially no drugs to help you out. They simply haven’t been manufactured in bulk yet; they do not exist. There are almost no monoclonal antibodies available, and the antivirals like Paxlovid will not be readily available until February or March. There are no real out-patient treatments except Tylenol.

Please do everything you can to not get Omicron this month.

Here’s some perspective from the trenches: Quotes from Massachusetts doctor friends and colleagues

Emergency Room Physician: “It is horrendous. I can’t even get to the bottom of how horrendous it is here. The rooms, hallways, waiting room are all filled with COVID patients. Patients sit out in the waiting room for hours just waiting to be evaluated because there are not enough nurses. There are no beds in the hospital. Covid positive psych patients might actually stay the entire five quarantine days in the Emergency Department. Patients who are homeless have nowhere to go, no shelters, no hotels, no hospital beds. Some sit in the waiting room. Some go out into the cold. Some get lucky and stay in our hallways. We are a ship on an ocean of chaos and disaster with no lifeboats, no land in sight, no coast guard. That is how it feels.”

Emergency Room Doc (different ER): “My last shift in the ER we started with eight nurses instead of fourteen. Two nurses cried while they were working and one actually walked out and quit. We also had no secretary. So I had to answer the phone, draw my own bloods, transport patients. I have patients with no nurses for their entire visit, including one patient who had had a stroke. I found a patient who sat in their feces in the hallway for four hours. On top of that, I come in day after day and I’m surrounded by the same patients because the hospital is full to the brink and nobody is getting beds. We have 40 beds in our ER that are currently holding 50 patients waiting for medicine hospital beds and 20 patients waiting for psych beds. It’s a literal war zone. I cry after every shift. We are beyond drowning, we have drowned. The house of cards has collapsed.”

Hospitalist: “COVID admissions are through the roof. No ICU beds so only patients on ventilators or drips are being put in the unit. Patients still seem surprised by how sick they are. COVID+ family members asking why they aren’t allowed to visit. Then I open social media and see anti-vax and anti-mask posts in our local town groups. It’s emotionally exhausting.”

Hospitalist: “30–40% of my admissions have COVID and the unvaccinated can get very sick. I sent two patients to the ICU, one of whom was only 30. Many staff out sick, being told they have to return after 5 days and mask (you do not want to be in the hospital unless you absolutely have to since your doctor or nurse may be recovering from COVID while they care for you). Our whole hospital only got four doses of the monoclonal Sotrovimab this week and two are already used up; no idea when we’ll get more from the state. The National Guard has come here to help but the ER may have to close for lack of staff…..On the personal side, I just have to say it has been really hard. Like “question why you went into medicine” hard. Random outbursts of crying, hard. …I count myself lucky with supportive family and friends, amazing colleagues, I’ve started therapy, etc, but the repeated trauma is exhausting. Normally, I’m a calm, balanced, resilient person, but this has turned me into someone I don’t recognize.”

Hospitalist (from another hospital): “We had eight National Guardsmen come help out at the hospital. All now have Covid!”

Pediatric ER: “We usually have two nurse practitioners who follow up on Covid tests. It’s been taking 12 hours a day for them to call back all the patients. Now one is on vacation and the other one is sick. So now the docs are trying to do this on top of working in the ER. Every patient is “shocked” to hear they or their child has COVID.”

Neonatologist: “The sheer number of covid positive laboring women this week is insane — thankfully so far most are asymptomatic or mildly symptomatic.”

Family medicine: “I was on call over NYE weekend. Starting from 9am Friday it was call after call, 90% COVID related. Busiest call I’ve had in the seven years with my group. My husband joked that he’d build me a desk for the toilet so I could chart and pee.”

Psychiatry: “Our staff shortages are so terrible that we have had to start combining group homes meaning we have to move people with major developmental delays and things like schizophrenia from one house to another. It’s a nightmare. We are already paying staff extra & allowing asymptomatic COVID+ staff to work. On a personal level, I have developed hives & shingles from the stress.”

Community psychiatrist: I came back from vacation (where I covered myself for refills and urgent messages) and covered for three nurse practitioners, two sick, one with Covid. Other support staff out sick too. Widespread staffing shortages before the pandemic, now just ridiculous. Raging mental health and opioid crises. Kids out of school 3 of 5 days.”

Cancer surgeon: “I am a cancer surgeon and today I had to tell a woman with liver metastases that I cannot operate on her this month to remove her tumors because the hospital is full. She sat in my office and sobbed.”

Cancer surgeon: “I’m vaxed/boosted, came down with Covid this week and now my kids have it. OR time is so restricted I had to spend the whole week trying to get coverage for the week’s cases. Cried this morning because my rapid is still positive and so I can’t go back and I’m now trying to find coverage for next week’s cases too. These are cancer patients! I can’t take care of them, I can’t take care of my kids, I can’t take care of me.”

Rheumatology: “My immunosuppressed patients have been so careful but I had half a dozen patients turn positive in the last few days and I was only able to secure monoclonal antibodies for those on a certain med. Everyone else is out of luck.”

Internist: “We just got urgent instructions today to reduce in person visits and switch to telemed because of a staffing shortage. Our patients who get infusions are also getting bumped.”

Hematologist: “We have a bunch of patients who need blood transfusions every three weeks and we had to cancel some last week because there was no blood and we had to cancel some this week because there is no staff. The shock and horror — from us, from them — is just unbearable.”

Family Medicine Physician: “We typically have four medical assistants. Two have Covid, two others didn’t come in. We usually have four people at the front desk. Three have quit because they get yelled at too much. I have patients arguing with all of us about their positive results saying, “Why are you testing me for Covid, I just need antibiotics,” and “I can’t have Covid.””

Family Medicine: “Our triage nurse and two out of three secretaries were out. Tons of Covid patients. Every day I was in the office late returning calls. My husband tested positive and isolated so I had to do everything for the kids who have been remote this week. This weekend I’m working on 50+notes.”

Family Medicine: “40+ positives a day in our practice, can’t stay on top of all the phone calls. I have said over and over: there are no monoclonals, no antivirals, no treatments available, it’s unfortunate you didn’t get the vaccine, buy an oximeter and … good luck.”

Family Medicine: “Call after call, message after message of people with symptoms, exposure or both. All wanting to know how they can get tested (wait a week for an appointment through us or try your chances refreshing over and over online for an appointment, waiting in 6 hour lines, or going to an overwhelmed urgent care facility — several of which are closed due to staffing shortages) and how they can get monoclonal antibodies (sorry, none available except for the absolutely highest risk immunocompromised patients). I have nothing to offer anybody other than tylenol and instructing them on when to go to the ED.”

Family Medicine: “I felt so badly this week-end for my COPDers who were calling to get monoclonal antibodies, and I had to say it was unlikely they would get them.”

Family Medicine: So many people are out I’m now working seven days a week… Exhausted…And the patients who refuse to wear their masks! They say, ”There is no way, I don’t have covid” but the next day: positive. They don’t seem to care if they make me sick.”

Family Medicine: “This week every day I had people newly positive. Everyone. Young (40 and under), older, kids, pregnant women. Half of our labor floor was COVID positive. There are new treatments but they aren’t actually available. So I’m left to tell people that there is nothing I can offer except symptomatic treatment. Over and over and over again.”

Family Medicine: “Was on call over NYE: it was an absolute horror story. On Friday I think of all the patients I saw, all but two had covid. I had to send four kids under two to the ER and one we had to send one out with ALS (advanced life support) for ICU care. Came in the afternoon after the storm: every sick patient I saw had Covid while my staff was out with kids at home with Covid. I started answering my pages and phone calls with, “Hi, this is Dr. Covid, I mean…” Not only physically exhausted, and my autoimmune diseases flaring from the stress…. I miss my family. My husband got a breakthrough covid infection — he found out when he tested on Christmas Eve to be safe before visiting family. Positive: another Zoom Christmas. … Despite all of the above, I’m happy to do this. Just… so… tired…”

Family Medicine: “I did a well-check on a toddler last week. Her father told me flat out that no one in his family would ever be getting a covid vaccine because “I am not afraid of covid, I am not afraid of my kids getting covid…” and the hardest to hear of all “I don’t care about anyone else.” It took every fiber of my being to remain professional. So on top of the physical exhaustion, there’s that moral/ethical exhaustion for the gut punch when you’re already down…”

Internal Medicine: Friday we had to convert everything to Telehealth (or cancel them if their insurance wouldn’t allow) because each day of the week I lost a staff member who got sick with Covid. On Monday I had four staff, Tuesday there were three, Wed and Thursday we had two people and Friday I was the last one standing. Three people in my house have Covid. What on earth is going to happen tomorrow?

It is going to stay very bad in terms of staff and cases for the next few weeks.

Please do everything you can to not get Omicron this month.